The long-term objectives of this proposed MCRC continuation at UNC are to understand the causes of a variety of musculoskeletal conditions and to identify appropriate interventions and effective means to deliver them, to treat and prevent rheumatic diseases and their consequences. This application proposes 1) to conduct rigorous interdisciplinary clinical research in osteoarthritis (OA), rheumatoid arthritis (RA) and patient-reported arthritis outcomes; 2) to support the methodological and statistical needs of four proposed projects and future projects; and 3) to foster the development of new research in arthritis and musculoskeletal diseases. As the foundation of the Center, the Methodology Core will provide: 1) methodological/ biostatistical consultation; 2) measurement development; 3) data support services; 4) data and safety monitoring; and 5) education. The four projects maximize efficiency and impact of extant studies for minimal additional cost. Project 1, The role of metals exposure in the severity and progression of generalized OA (Principal Investigator [PI]: Dr. Joanne Jordan), examines metals and OA biomarkers and generalized OA in the Johnston County Osteoarthritis Project; Project 2, Individual and community social determinants of outcomes in RA in African Americans (PI: Dr. Leigh Callahan), examines individual and community determinants of outcome, particularly segregation and perceived discrimination, in African Americans with RA in the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis; Project 3, Applying modern measurement approaches to psychosocial variables in arthritis research (PI: Dr. Robert DeVellis), utilizes the NIH Roadmap Patient Reported Outcome Information Systems (PROMIS) and other arthritis datasets to assess and improve psychometric properties of psychosocial measures widely used in arthritis research; and Project 4, Communicating risks associated with prescription medications (PI: Dr. Susan Blalock), examines patient-physician communication of medication risks in patients with RA, utilizing data from the NIA-funded study Older adults and drug decisions. The projects use epidemiologic and bio-behavioral approaches to patient populations in OA, RA, and general rheumatologic conditions to advance the public health by identifying novel risk factors for OA and RA, improving outcome measurement, and improving communication about medication risks.